Microfat grafting or BRAVA doctor recommendations
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Thanks Lee Got it, great energy from her on that procedure. I called and left a message with her office and within an hour they called me back. The person i spoke with was so cool,very nice and infomative,geez what a difference an office can make after my talk with Cindy. Dr Grenberg is up and ready to go! The office person and i spoke about insurance a little not discouraging at all. So with alot of bco help and perseverance maybe i found my fit i also have an appt with Dr. Trott next week. So i have 2 ps's that do dr.Khouri's procedure we got HOPE! thanks to all god bless!
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That's great! Good luck - I really hope your consults go well. Things are looking up! Good thoughts! 0 -
Beacher-just had a consult today from a Dr who does FG. She said my issues would not be fixed with FG alone. She thought the best fix for me is a lat flap. I really don't want to do that. But she believes using your own body tissue is the best. She's not too keen on the whole TE and implant reconstruction. In my case I need some pocket work, implants lifted and then some FG. She said all of this however is not guaranteed to work either. She does know Dr. Khouri and just said he is very aggressive. Not sure what she meant by that. I think it was a compliment. She didn't comment really on if his method would help me because she thinks I have other more complicated issues. My point is however, she did mention the lat flap thing so I wonder if that is something you have considered or are you like me where you flat out don't want that method.
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HI Sweete2040, thats too bad this Dr. would not think of you as a candidate,maybe you should try another if that is what u want. i really do not want the lat flap but was considering the diep at one point. But until the fatgrafting is completely a no im not going there yet. I will pm you to give you some dr.s i am consulting with. i will keep you posted and try to help you as much as i can. take care,i am in California though,but we can learn and share still
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Thanks everyone for all your pm's, special ladies, glad to know i am not alone! but wish and hope the best for all of you too! Thanks for really getting it! God Bless....
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beacher I'm so glad you found two PS's to go and talk too. I know you have been miserable.
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Great discussions!! This is almost like a reality show without the picture. We're all dealing with big decisions and helping one another. Love it. I'm the #1 Brava/lipid inject case for U of Washington (Dr. Peter Neligan). Have 1 1/2 weeks before surgery and am in the cycling portion of the presurgery workup. Everything's been doable. The device is awkward but the long term results will be so worth it. Just takes a little discipline. Have been in touch with Brava coach, Darlene, who's been a phenomenal help. I'm soooooooo glad I didn't go with an implant. I did have a DIEP which became necrotic, therefore, the reason for going down the Brava road. I do believe this will eventually be a great option for women, rather than the invasive procedures, even though they are doable as well. Will stay in touch to let you know how it goes.
J
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Sherryc,Thanks so very much for your thoughts! I really hope you are doing well? let me know?
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jseda- Thanks for sharing your contacts! Wishing you the best of luck!
I sent an email to Dr. Lauren Greenberg's office in Palo Alto asking if she has started taking patients, yet, for the fat grafting for breast reconstruction. She personally emailed me back and said she is accepting patients and that she is going to "mimic Dr. Khouri as close as possible in his methods". I know some of you will want to wait until she has more experience but I think she could end up being a good source on the west coast. She is educated at Dartmouth, Northwestern University and Standford and seems genuinely excited about this procedure. Here's her contact information-
Dr. Lauren Greenberg MD (Board certified in plastic surgery.)
750 Welch Road, Suite 117, Palo Alto, CA 94304
650-617-9907
laurengreenbergmd.com
There is a link on her website where you can email her with questions. I got a response within a day.
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Hi Jseda -- how great that you found someone on the west coast that is starting to do the Brava/fat grafting. There is another forum site fatgraftpatients.com with a lot of support for Brava users, what to pack for surgery, compression garments, tips for Brava wear, and women who are going thru the process at the same time as you. You are welcome to join us over there as well.
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I have to say I am really impressed with Dr Lauren Greenberg.
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Hi, yes i had talked with Doctor Lauren Greenbergs's office last week and they were wonderful and so helpful. She is definitely ready to do fat grafting with the Brava. I think i had posted it ,or maybe on another thread. They were so nice she wanted to make an appointment for a consultation right then, and i almost did it
My son lives in San Francisco which is bout 18 miles away so its a definite consultation for me after the first of the year. I hope you are able to do the same Lalisa. All of us looking out here on the west coast have been blessed.0 -
So excited to hear about Lauren Greenberg and that this might be an option that works for you, Beecher and maybe Lalisa! I think she is going to have a dynamic practice!
Just came to this site to record a few options I have heard about:Robert Ferguson in Utah
Dr. Chris Nichols Tacoma, WADr. Barbara Hayden- (310) 315-0215- Santa Monica, CA
(have heard she only does surgery once a month, so will need to check on that)
Dr. Allan Wu- (760) 202-2770- Rancho Mirage, CAYou'll need to check on each of these to find out for sure.
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Leaving soon for my appointment today with Susan Trott in Beverly Hills (310) 275 3990!
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Lalisa, hope your appointment went well. I would love to hear all about it as I am now considering fat grafting and looking into west coast options.
Beacher4209, who did you talk to at Dr. Greenberg's? I called her office a couple of hours ago and the person I spoke to was not helpful at all.
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geez JlK i did not take a name, i hate hearing this.....Why does this have to be so hard? I am going to start taking down office people names now! pm me (private message for those having touble with abbreviations) and let me know what happened....
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I saw Dr Trott and think she is great. I encourage anyone in the SoCal area to consult her. I just posted more in the other microfat thread.
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Lalisa--congrad's on finding such a promising PS in LA. Good Luck,
I am also interested in fatgrafting--but request recommendations specifically on fatgrafting with a PS in New York, New York.
If any forum members have such a recommendation--please post. Thanks, Eileen
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Lalisa - thank you for the update :-) I just called Dr. Trott's office and the person I spoke with was very helpful. I am going to send in photos and see what Dr. Trott has to say.
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Hello everyone,
I had my bilat on Sept 15. Went to Intimate Image to look at prosthesis. The lady at Intimate Image had gone through a unilat mast years ago with no recon. I told her about Dr. K's fat grafting and about Dr. Greenberg. She said she is going to get the data off the website and prepare handouts for the women who come in. She said many are so depressed after surgery re the options for recon that they are given and decline.
In addition, when I saw my surgeon for post op I also gave the info on Dr. K and Dr. Greenberg to his assistant, Susan, whose sister had bilat with no recon. She said besides her sister there was someone she was going to call immediately who lived near Dr. Greenberg. I have since emailed Susan the names of the others on the West Coast -Trott, Hayden and Wu.
I am doing whatever I can to get the word out so that this will become the next gold standard in reconstruction and all the insurance companies will be forced to recognize and pay for it.
Kathy in Chatsworth.
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Awesome Kathy!!
What would I give to have found this option PRIOR to my double mx?! I'm happy to have the option now..but wow.
Dr K told me once that he hopes women do come forward and speak out...especially to their surgeons and demand better care. He said his goal is not to have women flying from all over to him for care...but for surgeons to become better trained with more cutting edge techniques as a result of these women coming to them saying "Hey, get with the program".0 -
Hi All,
I am interestedd as well if there are ps doing this in Philly, N.Y...... or is it yet to come.
thanks
CR
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Great work Kathy!!!!
Like Geewhiz I wish I had known about this BEFORE but still feel very lucky to have had this as my revision.
It must become the standard - we simply have to continue to spread the word.
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Kathy- Ditto what Lee said- GREAT WORK!
Chocolate- If you read through this whole thread there are some surgeons listed in the NY area- Dr. Christina Ahn, Dr. Julie Vasile and Dr. David Greenspun. There are some listed in Connecticut as well. Good luck!
I just read throught this thread and am starting a kind of log of any doctors I see listed for each state. Thought it would be nice to have it in one place. It would at least give someone a starting point. Maybe I'll even start a new thread with the names listed by state in the first post and can edit as needed.
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Jlk,i responded to your private message also ,but give Dr. trotts office a call ,Lalisa had a good experience with her consult. I am going this Thurs. for my consult and will pass this my experience on also Take care for now,u are not alone in this...
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kate33--we can add Dr. Nolan Karp--does implants with fatgrafting to the New York, New York list. Great idea to have names in different locations.
Eileen
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Hi I all- I apologize but could you direct me to the list (feeling pretty dumb at this moment) So sorry. Thanks
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I am trying to compile a datebase of PS's who are offering fat grafting. I have been emailing them and trying to find out exactly what type of fat grafting they do and how they are using it. I just emailed Dr. Lawrence Koplin in Beverly Hills and he personally emailed me back. He was extremely kind and caring. Here is his contact information-
Dr. Lawrence Koplin
465 N. Roxbury Dr,. Suite 800, Beverly Hills, CA 90210
310-277-3223 Website- drkoplin.com Email- lkoplin@drkoplin.com
I'm going to copy and paste portions of our email correspondence, too-
Dear Dr. Koplin-
Would you please tell me if you are currently offering fat grafting for
total breast reconstruction or as a way to augment breast reconstruction?
And, if you are, do you use the BRAVA system in your technique?
I am a regular poster on breastcancer.org and am trying to establish a
database of surgeons offering this procedure to assist breast cancer
patients interested in pursuing this option for reconstruction.
If you are not currently offering this technique, but know of another
surgeon who is, I would appreciate that information as well.
Thank you for your time.
Hello, Kate!
First of all, please accept my thanks for having contacted me. There are so many places patients look for information, and it is a fabulous idea to be compiling this type of database to help them find the quality surgeons they deserve.
Without getting too technical (although I can if you don't get too bored-
feel free to ask), I have refined my thoughts about breast reconstruction to
several distinct categories.
For patients who have had true mastectomies, and have had fairly large
breasts, total breast reconstruction with fat grafting is a multi-stage
procedure that requires a large amount of fat to donate, BRAVA to stretch
the skin, and quite a long journey.
For a patient who has lost a small and well-shaped breast and has the fat to donate, then BRAVA and 2-3+ procedures really are a viable alternative to be considered.
More to my passion and focus are women who have partial breast defects from aggressive lumpectomies followed by radiation therapy, and aren't "fixable" with implants even if they wanted them. For this large group of patients, I am extremely passionate about offering fat grafting/transfer as the absolutely best alternative for them!
The final thing I do often and very well is to "finesse" and "rescue" breast
reconstructions that have not gone well- using fat grafting to fill defects,
round out areas of deficiency, and hide implants that are visible under
extremely thin skin. I am extremely comfortable in this world of frustrated
and confused patients- I have been actively researching and performing fat
grafting since 1985 and have successfully treated thousands of patients in
all areas of fat transfer.
I hope this helps. Please feel free to write back and ask any additional
questions I might be able to answer for you.
With warm regards and thank you again for contacting me,
Lawrence M. Koplin, M.D., F.A.C.S.
Dear Dr. Koplin-
I appreciate so much your reply and all the information you shared. I
recently had fat grafting done by Dr. Roger Khouri in Miami, Florida
and it made a huge difference in my overall reconstruction results.
(It worked wonders for hiding the implants under my thin skin just as
you described.) After posting my story I have been inundated by
emails from other women trying to find a surgeon in their own area who
does this procedure as well, particularly on the west coast. I am so
pleased that I finally have a name to pass on to them.
I post on several threads on breastcancer.org regarding fat grafting,
issues with implants such as rippling and overall dissatisfaction with
reconstruction results. I was wondering if you would mind if I shared
what you have written to me in this email and your contact
information? There are many women posting regarding Dr. Khouri but
very little information about other surgeons who also offer fat
grafting. I will wait to hear from you before doing so.
Since you offered I do have a few questions for you. I hope I'm not
taking advantage of your kindness. I am really just trying to educate
myself as much as possible since so many women are turning to me for
help.
Many women, myself included, are experiencing discomfort due to the
stretching and tightness of the pectoral muscles following the use of
the tissue expanders and now implants. If a women is able to use the
BRAVA system, go through several rounds of fat grafting and have the
implants removed all together is there anything that can be done to
restore the pectoral muscles to their original condition? This seems
to be a question on everyone's mind. During my surgery with Dr.
Khouri he swapped out my implants for much smaller ones and, at first,
the relief was amazing. Over the past four months, though, the pecs
seem to have tightened up again and the pain has returned. This is
another issue I see being discussed time and time again on my forum
and I have never seen it addressed by any surgeon.
Also, regarding fat grafting to improve defects post following
lumpectomy and/or mastectomy do you accept insurance and is it your
experience that this is typically covered? There seems to be a huge
disparity among surgeons/insurance companies regarding the coverage of
this. It is very frustrating for some women to know there is
something out there that would improve things only to find out it is
beyond her reach.
Thank you again for your time. You have no idea how refreshing it is
to find a physician who goes out of his way to make this information
more accessible to women. Your email alone shows your caring nature
and I will pass this along to anyone seeking out a surgeon in your
area.
Sincerely,
Kate Smith
Good evening, Kate!
Sounds like we are all on similar tracks, and that you have had great experiences with Dr. Khouri. He is, of course, a champion of all things fat grafting and we all all indebted to his skill and teaching. Although he doesn't know me, his "Mentor" Dr. Thomas Biggs, knows me extremely well. He was my professor of plastic surgery in Houston, and can give any references you might wish.
You are of course most welcome to publish any and all of my email comments, and my contact information as well. I don't think there are many surgeons on the West Coast doing these types of procedures, and I would be most honored to be included in your posts. Also, feel free to ask additional questions at any time, or even call at your convenience- all my info is on my website, which will undergo a fabulous upgrade in the next couple months.
Finally, as for pectoral muscle issues. This is perplexing to me, as I really have NO complaints such as these in my patients. I place implants exclusively under the muscle. I use textured gel implants as my first choice, as these seem to have the lowest rates of capsular contracture (firmness, tightness, etc.). The only time I hear of these chronic issues of tightening and pain is when capsular contractures recur (return). This could be your case as well.....? Again, in patients who have had expanders, then implants.... everything should return to normal anatomy and function (without pain or tightness) unless contracture is present. Many studies have shown that patients with soft implants have totally normal pectoralis function, strength, range of motion and comfort.
I know Dr. Khouri, and other visionaries like him, often charge very reasonable fees for their fat grafting reconstructions. I feel similarly, especially in breast cancer patients. Yes, insurance should well cover fat grafting to lumpectomy defects.... but they don't always. They should, as the law currently requires insurance companies to restore breast cancer patients to their "normal" state. We always check insurance first and try very hard to preauthorize coverage. Still, it is one of the joys and pleasures of being a physician to treat the patient rather than the bank account; we never turn anyone down for a breast reconstruction for financial reasons.
I hope this helps. Keep up the good work!
With best wishes,
Lawrence Koplin, M.D.
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Hi Kate,
Great post!
I am curious as to how you found Dr. Koplin as his website does not even mention fat grafting for the breast.
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I was wondering too - after I read your post I clicked all over his website and I didn't find anything (except FG to face) either. Tell us your secret, you super sleuth!
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